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Improving interMediAte Risk management. MARK study
Martí, Ruth; Parramon, Dídac; García-Ortiz, Luís; Rigo, Fernando; Gómez-Marcos, Manuel A.; Sempere, Irene; García-Regalado, Natividad; Recio-Rodriguez, Jose I.; Agudo-Conde, Cristina; Feuerbach, Natalia; García Gil, María del Mar; Ponjoan, Anna; Quesada, Miquel; Ramos Blanes, Rafel
Background: Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design: This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion: Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect
Sistema cardiovascular -- Malalties
Atenció primària
Primary care (Medicine)
Riscos per a la salut -- Avaluació
Health risk assessment
Sistema cardiovascular -- Prevenció
Cardiovascular system -- Prevention
Cardiovascular system -- Diseases
Attribution 2.0 Spain
BioMed Central

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